Use of reliable contraceptives and its correlates among women participating in Simulated HIV vaccine efficacy trials in key-populations in Uganda

Abaasa, Andrew; Todd, Jim; Mayanja, Yunia; Price, Matt A.; Fast, Patricia E.; Kaleebu, Pontiano; Nash, Stephen

doi:10.1038/s41598-019-51879-2

Cited by 3 publications

(5 citation statements)

References 33 publications

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“…Variables include: personal factors – fear of side effects [ 10 , 51 ]. desire for (more) children [ 11 ], being nulliparous [ 46 ], history of incarceration or arrest [ 55 ], intoxication [ 42 ], and being older than 35 [ 31 ]; interpersonal factors—male partners’ or clients’ disapproval [ 10 ], physical or sexual abuse [9, 16], having a steady partner [ 51 ]; and systemic issues—poor clinic access [ 10 , 42 ], negative healthcare provider attitudes [ 10 ], and condom availability at work [ 55 ]. Use of non-barrier contraception was found in to be associated with ease of access, positive healthcare provider attitudes, conducive clinic schedules, fewer side effects [ 56 ], previous pregnancy, positive attitude to and knowledge of family planning, younger age, and lower education [ 18 ].…”

Section: Resultsmentioning

confidence: 99%

Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review of Non-Barrier Contraception, Pregnancy and Abortion

Macleod¹,

Reynolds

Delate³

2022

Public Health Rev

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Objectives: There is a need to hone reproductive health (RH) services for women who sell sex (WSS). The aim of this review was to collate findings on non-barrier contraception, pregnancies, and abortion amongst WSS in Eastern and Southern African (ESA).Methods: A scoping review methodology was employed. Inclusion criteria were: 1) empirical papers from 2) ESA, 3) published since 2010, and 4) addressing WSS in relation to 5) the identified RH issues.Results: Reports of rates of non-barrier contraceptive usage varied from 15% to 76%, of unintended pregnancy from 24% to 91%, and of abortion from 11% to 48%. Cross-cutting factors were alcohol use, violence, health systems problems, and socio-economic issues. Pregnancy desire was associated with having a non-paying partner. Barriers to accessing, and delaying, antenatal care were reported as common. Targeted programmes were reported as promoting RH amongst WSS.Conclusion: Programmes should be contextually relevant, based on local patterns, individual, interpersonal and systemic barriers. Targeted approaches should be implemented in conjunction with improvement of public health services. Linked HIV and RH services, and community empowerment approaches are recommended.

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Section: Resultsmentioning

confidence: 99%

Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review of Non-Barrier Contraception, Pregnancy and Abortion

Macleod¹,

Reynolds

Delate³

2022

Public Health Rev

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“…Encouraging women to receive their contraception injection or take their pills on time through phone calls and/or home visits would improve adherence. 47 …”

Section: Trial Requirements Contraception Stipulations and Their Impact On Women’s Participation – From A Gender And Health Policy Analysmentioning

confidence: 99%

“…Some key areas of concern in terms of women's participation in HIV clinical trials include: 'Reliable' and 'unreliable' contraceptives Study criteria may divide contraceptives into 'reliable' contraceptives (such as injectable DMPA, implant, oral pills, and IUD) and 'unreliable' contraceptives (such as condoms, lactational amenorrhea, and withdrawal). Some trials promote 'reliable' contraceptives to women who are not using any method or who are using an 'unreliable' method (as in the case of Abaasa et al 47 ).…”

Section: Contraceptive Requirements As a Barrier To Women's Participa...mentioning

confidence: 99%

“…Encouraging women to receive their contraception injection or take their pills on time through phone calls and/or home visits would improve adherence. 47 Protection from STIs and HIV for trial participants When contraceptive eligibility requirements exclude condoms and actively promote other methods, are women also advised and supported to continue using condoms if they want to ensure protection from STIs and HIV for themselves or their sexual partners? A focus on avoiding pregnancy for the requirements of the trial may contribute to women's need for STI and HIV prevention being ignored or deprioritised.…”

Section: Contraceptive Requirements As a Barrier To Women's Participa...mentioning

confidence: 99%

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From presumptive exclusion towards fair inclusion: perspectives on the involvement of women living with HIV in clinical trials, including stakeholders’ views

Namiba

Kwardem

Dhairyawan

et al. 2022

Therapeutic Advances in Infection

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2journals.sagepub.com/home/tai black women were under-recruited by around 35%. They also found that despite most of the global burden of HIV being in low and low-middle-income countries, most of the trials were carried out in high and high-middle-income countries. A systematicreview 5 of HIV cure research published in 2015 found that women, as well as older people and those of non-white ethnicities were profoundly under-represented.This pattern of under-recruitment is not only seen in HIV, but in many disease areas including cardiovascular disease, 7 cancer, 8 and mental health conditions. 9 Sex and gender differences 10 in the prevalence,incidence, 11 symptomatology, andprogression 12 of a range of diseases have been described, as have differences in responses to treatment. These differences in treatment responses are likely to be attributable to differences in how the body deals with a drug (pharmacokinetics) and the effect of the drug on the body (pharmacodynamics). This may affect the efficacy and tolerability of thedrug. 13 Importantly, sex 14 and gender 15 inequalities 16 in social and economic power also have a large impact on health outcomes, affecting health-seeking behaviour, access to, and utilisation of healthcare services.journals.sagepub.com/home/tai 13Visit SAGE journals online journals.sagepub.com/ home/tai

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“…While studies have assessed the need for contraception among women at high risk of HIV infection ( 14 – 16 ), most have been conducted among older women. Yet AGYW at risk of HIV infection may have specific challenges seeking appropriate contraception, such as socio-cultural norms against young unmarried girls being sexually active and poor attitudes from the health care workers towards young girls seeking contraception ( 17 ).…”

Section: Introductionmentioning

confidence: 99%

“I fear those things”: non-uptake of contraceptives, and barriers to use among adolescent girls and young women at high risk of HIV infection in Kampala, Uganda

Kawuma

Lunkuse

Ssembajjwe

et al. 2023

Front. Reprod. Health

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BackgroundAdolescent girls and young women involved in risky behaviors are vulnerable to multiple health problems, yet sexual and reproductive health services remain underutilized. We evaluated factors associated with non-uptake of contraceptives and barriers to use among adolescent girls and young women (14–24 years old) at high risk of HIV infection in an environment where contraceptives were provided at no cost.MethodsWe conducted a mixed methods study, utilizing data from a baseline cross sectional survey and qualitative in-depth interviews. Survey participants tested negative for pregnancy and reported willingness to use contraception. Non-uptake of contraceptives was defined as not taking contraception at any study visit (baseline and throughout the study). Logistic regression model was used to assess factors associated with non-uptake of contraceptives. We purposively selected participants for interviews to discuss their knowledge and experiences with contraceptives and make suggestions to improve uptake. Qualitative data were analyzed thematically.ResultsAll 285 participants were included in the analysis. Out of the 285 participants 127 were not using contraceptives and of the 127, 44 (34.6%) did not take up any method throughout the study while 43 of the 83 remaining participants (who took up a method) chose male condoms only. Non-uptake of contraceptives was less likely among older women (20–24 years) (aOR = 0.32, 95% CI 0.16–0.89) compared to younger women (less than 20 years). Qualitative data showed that concerns about future fertility, fear of associated side effects and influence from close relations contributed to non-uptake of contraception.ConclusionNon-uptake of contraceptives was common despite the promotion and provision of contraceptives in the context of a research study mainly because adolescents lack autonomy while making contraceptive decisions. Identifying and addressing their concerns and continued counselling on contraceptive use alongside condom promotion may improve uptake and utilization of contraceptives.

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Use of reliable contraceptives and its correlates among women participating in Simulated HIV vaccine efficacy trials in key-populations in Uganda

Cited by 3 publications

References 33 publications

Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review of Non-Barrier Contraception, Pregnancy and Abortion

Women Who Sell Sex in Eastern and Southern Africa: A Scoping Review of Non-Barrier Contraception, Pregnancy and Abortion

From presumptive exclusion towards fair inclusion: perspectives on the involvement of women living with HIV in clinical trials, including stakeholders’ views

“I fear those things”: non-uptake of contraceptives, and barriers to use among adolescent girls and young women at high risk of HIV infection in Kampala, Uganda

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